类风湿关节炎合并腘窝囊肿的临床分析

doi:10.3969/j.issn.1004-583X.2019.03.010

摘要/Abstract

摘要： 目的分析类风湿关节炎（rheumatoid arthritis, RA）合并腘窝囊肿的临床诊疗特点及预后。方法收集免疫风湿科2010-2018年收治的62例RA合并腘窝囊肿患者的临床资料，并选取同期收治的50例RA未合并腘窝囊肿患者作为对照。结果与未合并腘窝囊肿患者比较, 合并腘窝囊肿患者总病程较长(P=0.040)，RA活动比例升高(P=0.012)，膝关节受累、首发受累关节为膝关节、行走受限者比例增多(P<0.05)。62例合并腘窝囊肿患者中12例囊肿破裂、50例囊肿未破裂。腘窝囊肿破裂患者的年龄≥65岁者比例增多（P=0.040）、囊肿面积≥16 cm2者比例增多(P=0.043)，Rauschning和LindgrenⅢ级者比例增多(P=0.046)，入院时膝关节肿痛缓解者比例增多(P=0.000)。多元回归分析显示，DAS28评分高、总病程长、首发受累关节为膝关节、系统损害数≥3个为RA患者发生腘窝囊肿的危险因素。RA合并腘窝囊肿的治疗方案包括药物治疗和药物联合关节腔穿刺治疗，采用药物联合关节腔穿刺治疗的患者比单纯药物治疗的患者起效时间更快，小腿肿胀、疼痛症状缓解更快(P=0.000)；两种方案的治愈率及复发率比较差异无统计学意义(P>0.999)。结论 RA患者的病程越长，病情活动越明显，系统损害越严重，越容易出现腘窝囊肿；合并的腘窝囊肿越大，其破裂的风险越大；药物联合关节腔穿刺治疗起效时间更短，症状缓解更快。

关键词: 关节炎, , 类风湿 , 腘囊肿, 治疗

Abstract: Objective To analyze the clinical characteristics and prognosis of rheumatoid arthritis (RA) with popliteal cysts.Methods General condition, clinical manifestations, laboratory tests,treatment and prognosis of 62 patients with RA with popliteal cysts admitted to the Department of Rheumatology and Immunology, Changzhou First People's Hospital from 2010 to 2018were collected, 50 patients with RA without popliteal cysts were selected as comparisons. Results Compared with patients without popliteal cysts,patients with popliteal cystshad a longer duration (P=0.040), the proportion of patients with RA in activity， knee joint involvement increased significantly, the proportion of firstinfested joints in the knee joint increased significantly ,the proportion of people with limited mobility increased significantly (P<0.05). Of the 62 patients, 12 had a ruptured popliteal cyst and 50 had no rupture of the popliteal cyst. Compared with patients with unruptured popliteal cysts, the proportion of patients with ruptured axillary cysts aged ≥65 years old increased (P=0.040), the proportion of cysts ≥16 cm2 increased (P=0.043) , the proportion of Rauschning and Lindgren Ⅲ patients increased (P=0.046), the proportion of patients with reduced knee pain and swelling at admission was significantly higher than that without ruptured(P=0.000). Logistic multivariate regression analysis showed that DAS28 score, the total duration of the disease, the first joint affected was the knee joint, and the number of systemic damage ≥3 werethe risk factors for the occurrence of popliteal cyst in patients with RA. The treatment of RA with popliteal cysts included drug therapy and drug combined with joint cavity puncture. Patients treated with drugs combined with joint cavity puncture hada faster onset than patients treated with drugs alone.Symptoms of swelling and pain in the calf wererelieved faster (P=0.000).The cure rate and recurrence rate of the two regimens were not statistically significant (P>0.999).Conclusion The longer the course of disease of RA patients, the more obvious the disease activity, the more serious the system damage,the moreprone to popliteal cysts;the larger the cyst, the greater the risk of rupture.Drug combined with joint cavity puncturetreatment has a shorter onset time, symptoms are relieved faster.

Key words: arthritis, , rheumatoid, popliteal cysts, therapy

王增增，徐婷，吴敏. 类风湿关节炎合并腘窝囊肿的临床分析[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.03.010.

Wang Zengzeng, XU Ting, WU Min. Clinical analysis of rheumatoid arthritis complicated with popliteal cyst[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.03.010.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2019.03.010

https://huicui.hebmu.edu.cn/CN/Y2019/V34/I3/248

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类风湿关节炎合并腘窝囊肿的临床分析

Clinical analysis of rheumatoid arthritis complicated with popliteal cyst

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